Use of reamed locked intramedullary nailing in the treatment of aseptic diaphyseal tibial non-union
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2007, Vol 9, Issue 4
Abstract
Introduction: Tibial fractures have been associated with the highest rates of bone union disturbances for many years. Stabilization of the tibial shaft with a reamed intramedullary nail is now being increasingly recommended as a treatment of choice. The aim of this study was to evaluate the outcomes of treatment of tibial shaft non-union with reamed intramedullary nails locked distally and proximally. Material and methods: Thirty-three patients (11 females and 22 males) with tibial shaft non-union were treated by locked intramedullary nailing. There were twelve patients with a biologically active non-union, while in the remaining 21 the non-union was biologically non-active. The diagnosis was based on case history, physical examination and X-ray data. The average non-union time was 26.96. An intramedullary nail was inserted according to the technique recommended by AO/ASIF. Follow-up examinations were performed at six-week intervals until bone union was obtained. The diagnosis of bone union was based on physical examination and X-ray evidence. The functional outcome was assessed according to the Johner-Wruhs scale. Treatment failure was defined as the absence of clinical and radiological signs of bone union 12 months after surgery.Results: Bone union was achieved in 94% patients following an average time of 37.2 weeks. The functional outcome was classified as good or very good according to the Johner and Wruhs scale in 60% of the patients, while 18% of the patients were diagnosed to have a poor functional outcome. An infection of the non-union site was found in 6 patients, of whom two developed a chronic infection (in one patient bone union was not achieved).Conclusion: 1. The treatment of an aseptic non-union of the tibial shaft with an intramedullary nail is an effective procedure.. 2. This conclusion must be regarded as tentative in view of the small sample size.
Authors and Affiliations
Łukasz Niedźwiedzki
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